Provider Demographics
NPI:1427439199
Name:MUKUNDA, HARSHITHA (DDS)
Entity type:Individual
Prefix:
First Name:HARSHITHA
Middle Name:
Last Name:MUKUNDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10340 S DECATUR BLVD
Mailing Address - Street 2:UNIT 3059
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141
Mailing Address - Country:US
Mailing Address - Phone:630-903-1100
Mailing Address - Fax:
Practice Address - Street 1:8035 S RAINBOW BLVD
Practice Address - Street 2:STE 102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139
Practice Address - Country:US
Practice Address - Phone:702-896-7211
Practice Address - Fax:702-896-7099
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012789A1223G0001X
NV8208122300000X, 1223G0001X
IL019030340122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist